Brisson Nicholas M, Wiebenga Emily G, Stratford Paul W, Beattie Karen A, Totterman Saara, Tamez-Peña José G, Callaghan Jack P, Adachi Jonathan D, Maly Monica R
School of Rehabilitation Science, Institute for Applied Health Sciences, McMaster University, Room 403, 1400 Main Street West, Hamilton, Ontario, L8S 1C7, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
J Orthop Res. 2017 Nov;35(11):2476-2483. doi: 10.1002/jor.23564. Epub 2017 Apr 7.
This study aimed to determine the extent to which changes over 2.5 years in medial knee cartilage thickness and volume were predicted by: (1) Peak values of the knee adduction (KAM) and flexion moments; and (2) KAM impulse and loading frequency, representing cumulative load, after controlling for age, sex and body mass index (BMI). Adults with clinical knee osteoarthritis participated. At baseline and approximately 2.5 years follow-up, cartilage thickness and volume of the medial tibia and femur were segmented from magnetic resonance imaging scans. Gait kinematics and kinetics, and daily knee loading frequency were also collected at baseline. Multiple linear regressions predicted changes in cartilage morphology from baseline gait mechanics. Data were collected from 52 participants (41 women) [age 61.0 (6.9) y; BMI 28.5 (5.7) kg/m ] over 2.56 (0.51) years. There were significant KAM peak-by-BMI (p = 0.023) and KAM impulse-by-BMI (p = 0.034) interactions, which revealed that larger joint loads in those with higher BMIs were associated with greater loss of medial tibial cartilage volume. In conclusion, with adjustments for age, sex, and cartilage measurement at baseline, large magnitude KAM peak and KAM impulse each interacted with BMI to predict loss of cartilage volume of the medial tibia over 2.5 years among individuals with knee osteoarthritis. These data suggest that, in clinical knee osteoarthritis, exposure to large KAMs may be detrimental to cartilage in those with larger BMIs. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2476-2483, 2017.
本研究旨在确定在控制年龄、性别和体重指数(BMI)后,以下因素对膝关节内侧软骨厚度和体积在2.5年中的变化的预测程度:(1)膝关节内收(KAM)峰值和屈曲力矩;(2)KAM冲量和负荷频率,代表累积负荷。患有临床膝关节骨关节炎的成年人参与了研究。在基线和大约2.5年的随访时,从磁共振成像扫描中分割出胫骨内侧和股骨的软骨厚度和体积。在基线时还收集了步态运动学和动力学以及每日膝关节负荷频率。多元线性回归从基线步态力学预测软骨形态的变化。在2.56(0.51)年期间从52名参与者(41名女性)[年龄61.0(6.9)岁;BMI 28.5(5.7)kg/m²]收集数据。存在显著的KAM峰值与BMI(p = 0.023)以及KAM冲量与BMI(p = 0.034)的相互作用,这表明BMI较高者更大的关节负荷与胫骨内侧软骨体积的更大损失相关。总之,在对年龄、性别和基线时的软骨测量进行调整后,较大幅度的KAM峰值和KAM冲量各自与BMI相互作用,以预测膝关节骨关节炎患者在2.5年中胫骨内侧软骨体积的损失。这些数据表明,在临床膝关节骨关节炎中,暴露于较大的KAM可能对BMI较大者的软骨有害。©2017骨科研究协会。由威利期刊公司出版。《矫形外科学研究》35:2476 - 2483,2017。